Clinical Examples of CBT

Cognitive InterventionBelow are two examples or clinical vignettes that demonstrate a typical cognitive intervention called cognitive restructuring:Clinical Example 1A woman seeks help for low self-esteem. The therapist might help the client identify her automatic negative thought patterns called cognitive distortions. This stage of treatment is referred to as functional analysis. Together, they identify the client’s automatic thought, “I am worthless.” The therapist then helps her learn to interrupt this thought pattern and replace it with a more positive one of her choosing, such as “I have value.” They would attempt to do this with other cognitive distortions that contribute to her low self-esteem.Clinical Example 2A man is having interpersonal difficulties with his wife who is often late. With the help of the therapist, the husband might identify the meaning of his wife’s lateness. They discover that it means to him “my wife doesn’t love me.” The therapist then challenges his thought, asking him if this is in fact a reality. The therapist then helps him learn to replace this thought when it comes up with an alternative thought that the client feels to be true, such as “my wife loves me, she is simply disorganized.”

Behavioral InterventionCognitive behavior therapy also focuses on changing a person's unhealthy and problematic behaviors, actions, and responses. The focus is on replacing the problematic behavior with a more effective behavior.

Clinical Example 3A man recovering from alcohol addiction works with his therapist to identify high-risk situations that trigger the impulse to drink. Together they develop strategies for overcoming these impulses. The client begins to learn and practice new coping skills and rehearses ways, for example, to avoid or deal with social situations that might trigger a relapse. These might include relaxation techniques, mental distractions, or substituting another less harmful behavior. Click here to go back to the overview of cognitive-behavioral therapy.